Progress in AIDS battle, thanks to UNC study

A UNC-led research study has made a major discovery in efforts to halt the spread of HIV, the virus that causes AIDS.

The large international clinical trial, led by Myron S. Cohen, M.D., has found that treating HIV-infected individuals with antiretroviral therapy while their immune systems are still strong significantly reduces the risk of their sexual partners contracting the virus.

The findings are the first from a major randomized clinical trial to indicate that treating an HIV-infected person can make them less contagious, not just keep them healthy.

The study was due to run until 2015. However, data gathered so far clearly revealed the benefits of early treatment, prompting health officials to release the results now.

“We think that these results will be important to help improve both HIV treatment and prevention and we are grateful to the study participants for their important contribution in the fight against HIV/AIDS,” says Cohen, director of the UNC Institute for Global Health & Infectious Diseases.

The study, which spans nine countries, involved more than 1,700 couples, in which one partner was HIV-positive and the other was not. Each couple was randomly assigned to one of two study groups. In the first group, the partner with HIV began receiving antiretroviral drugs as soon as they enrolled in the study; in the second group, the infected partner started antiretroviral treatment once their CD4+ count — a key measure of immune system health — fell to between 200 and 250 cells/mm3, or when they developed an AIDS-related illness. Participants in both groups received HIV primary care, counseling and condoms.

According to the available data, which was reviewed by health officials in late April of this year, 27 previously uninfected partners in the second group contracted HIV from their partner. But in the first group, only one such case of new HIV infection occurred. This means that earlier initiation of antiretroviral treatment led to a 96 percent reduction in HIV transmission between a couple.

The study was conducted by the HIV Prevention Trials Network, which is largely funded by the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health.

“This new finding convincingly demonstrates that treating the infected individual — and doing so sooner rather than later — can have a major impact on reducing HIV transmission,” says the institute’s director, Anthony S. Fauci, M.D.

As well as leading the research, UNC had a study site in Malawi, where the University has conducted HIV research and provided treatment and training since 1989.

Cohen also is J. Herbert Bate Distinguished Professor of Medicine and Microbiology and Immunology at the UNC School of Medicine, professor of public health at the UNC Gillings School of Global Public Health, and associate director of the UNC Center for AIDS Research.